§ 27-19-40.1 - Third party reimbursement for services of registered nurse first assistants. - Rhode Island Statutes

SECTION 27-19-40.1

   § 27-19-40.1  Third party reimbursement forservices of registered nurse first assistants. – (a) Every individual or group health insurance contract, plan or policydelivered, issued or renewed by an insurer or nonprofit or for profit healthservice corporation which provides benefits to individual subscribers andmembers within the state, or to all group members having a principal place ofemployment within the state, shall provide benefits for services rendered by aregistered nurse first assistant designated as a registered nurse firstassistant provided, that the following conditions are met:

   (1) The registered nurse first assistant provides certainhealth care services under the supervision of a licensed physician; iscurrently licensed as a registered nurse in Rhode Island; has successfullycompleted a course in preparing the registered nurse as a first assistant inaccordance with the Association of Operating Room Nurses core curriculum guidefor the registered nurse first assistant and includes a minimum of one academicyear in a college or university with didactic instruction and clinicalinternship programs; and is certified in perioperative nursing by theCertification Board Perioperative Nursing (minimum of two (2) yearsperioperative experience);

   (2) The policy or contract currently provides benefits foridentical services rendered by a provider of health care licensed by the state;and

   (3) The registered nurse first assistant is not a salariedemployee of the licensed hospital or facility for which the nonprofit hospitalservice corporation has an alternative contractual relationship to fund theservices of a registered nurse first assistant.

   (b) It shall remain within the sole discretion of thenonprofit hospital service corporation as to which registered nurse firstassistant it shall contract with. Reimbursement shall be provided according tothe respective principles and policies of the nonprofit hospital servicecorporation; provided, that no nonprofit hospital service corporation may berequired to provide direct reimbursement, or pay for duplicative servicesactually rendered by a registered nurse first assistant in surgery and anyother health care provider. Nothing contained in this section precludes thenonprofit hospital service corporations from conducting managed care, medicalnecessity or utilization review.